What you need to know about:

Intrauterine Insemination (IUI)

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Overview of

Intrauterine Insemination (IUI)

in Thailand

Artificial Reproductive Technology techniques such as Intrauterine Insemination (IUI) helps infertile individuals achieve their goals by bypassing common causes of infertility.

IUI is performed by directly injecting concentrated sperm into the uterus. This is done right around the time where an egg is more likely to be released in order to increase the likelihood of fertilization.

IUI is coordinated with the woman’s own ovulation cycle. This process enables the healthcare providers to control factors such as the quality of the sperm and/or egg as well as the timing of fertilization. By placing the most viable sperm inside the uterus at the most opportune time, there is an increased chance that it will swim up to the fallopian tube and fertilize a viable egg.

In 2021, the World Health Organization posits that over 48 million couples or 186 million people struggled with infertility issues worldwide. Infertility is assumed when a man or a woman has failed to produce a pregnancy after 12 months of unprotected, regular intercourse.

Goals of

Intrauterine Insemination (IUI)

Just like all other forms of Artificial Reproductive Technologies, the goal of Intrauterine Insemination is to bypass common causes of infertility. These causes include problems with sperm mobility and anatomy, ejaculation, or if the woman’s cervical mucus is incompatible with sperm.

Since IUI directly deposits sperm into the uterus, it bypasses the cervix and ensures that the sperm reaches the uterus. Women who have endometriosis may also benefit from IUI.

IUI is the first line of treatment prescribed to couples diagnosed with unknown cause of fertility.  It may also be used with other forms of reproductive aides such as the administration of medication to improve egg quality and quantity.

Price of

Intrauterine Insemination (IUI)

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Pros and cons of

Intrauterine Insemination (IUI)

Pros

  • Considered as a less invasive and less expensive alternative to In-vitro Fertilization (IVF), IUI is one of the most popular ways to combat infertility.
  • Intrauterine Insemination is widely known to be a safe and effective way to produce a pregnancy. Other ARTs may involve the use of hormones or medications that may alter a woman’s natural ovulation cycle. In contrast, Intrauterine Insemination works with her natural cycle therefore lessening possible complications from medication therapy.
  • If a couple’s infertility problem is traced back to the sperm’s motility and quantity, then IUI is the most effective treatment pathway. This is because it circumvents the need for the sperm to be motile enough to travel through the cervix to reach the uterus.

Cons

  • One of the challenges of IUI is the higher risk for multiple pregnancies. While IUI alleviates other infertility challenges, it cannot control the number of fertilized eggs that may result from the procedure.
  • Currently, IUI’s success rate is at 5-15% which may be discouraging for some couples.
  • This procedure also requires close monitoring of the woman’s ovulation cycle which may be stressful. If the woman chooses to use her partner’s sperm, he will be asked to ejaculate at the clinic which may be an uncomfortable experience for some men. Women with damaged fallopian tubes are also not be eligible for this procedure.

How it works:

Intrauterine Insemination (IUI)

Couples or individuals who choose to undergo Intrauterine Insemination will be oriented to the risk, benefits, and possible cost of the procedure before their scheduled appointment. Patients are encouraged to ask questions and express their concerns at the initial consultation.

When an appointment has been made, make arrangements so that you and your partner have at least 2-4 days off work. This is to ensure that you are completely rested and ready for the recovery period.

If the partner’s sperm will be utilized, he will be guided to a private room and asked to provide a fresh semen sample. The sample will then be taken to the laboratory where the most motile and viable sperm will be selected and made into a sperm concentrate. This process will take around 2-3 hours. If donated sperm will be used, it will be thawed and examined before proceeding to the next phase.

The next step is to inject the concentrated sperm solution into the uterus. The woman is assisted into a comfortable position. The doctor inserts a thin tube into the vagina, then guided through the cervix to the uterus. Once a suitable area has been selected, the sperm will be released. Women may feel a slight discomfort during the process. If needed, pain relievers may be prescribed.

A pregnancy test can be attempted after 2 weeks. The urine test will be followed up with additional lab tests including an ultrasound. In some case, hormones may also be given to assist the pregnancy.

Preparation before

Intrauterine Insemination (IUI)

Pre - treatment

The preparation for this procedure will be different for each individual. As previously mentioned, laboratory workups may be done prior to the procedure. In some instances, hormones may be given to stimulate egg production. This process is done on the early days of the ovulation cycle. About 10 days after hormone administration, an ultrasound is performed to check on the quantity and quality of the eggs she produced. Once the eggs are determined to be viable, the couple will be asked to come into the clinic after 1-2 days to begin the process.

As you can see, timing is essential. Make sure that you and your partner are available when you are near your ovulation day. If you live far from the clinic, you may opt to find temporary housing while undergoing treatment.

As required by the Protection of Children Born by Assisted Reproductive Technology Act B.E. 2558, a Marriage Certificate/License or proof of relationship must be submitted prior to the procedure. If the couple was married outside of Thailand, the marriage certificate or license must be certified by the Thai Embassy at the country of registration. All documents must be in Thai or English.

Recovery after

Intrauterine Insemination (IUI)

Post - treatment

After the procedure, the patient is asked to stay flat on bed for a 20-to-30-minute observation period. Once cleared, the patient can be discharged and go about her usual daily activities. It is also advised that any activity involving heavy lifting or exertion is to be avoided for at least 3 days. Hormones may also be prescribed to help encourage pregnancy.

Pain relievers are prescribed to help manage discomforts such as light spotting and abdominal cramping -these symptoms are normal after IUI. However, should the woman develop active bleeding or experience moderate to severe abdominal pain, medical consult should be done immediately.

Risks & side effects

Your healthcare provider will give you a rundown of all of the things you should know about post-IUI care including risks and side effects.  IUI may be rescheduled if the ultrasound reveals too little or too much eggs were produced during ovulation. The most common side effect is vaginal spotting or bleeding due to the manual insertion of the tube into the vagina.  If the woman is given medication to enhance egg production, she may experience abdominal cramping for the first 2 days of ovulation. As previously mentioned, Intrauterine Insemination increases the risk for multiple pregnancies so the couple may want to explore the idea of having more than 1 child.

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Intrauterine Insemination (IUI)

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Watcharaporn Weerakul
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